Functional behaviour analysis guided interventions might improve transfer-related behaviour in dementia care dyads: a single case study

Abstract

Background: Impaired mobility in people with severe dementia is well known. Physical therapists play a key role in guiding professional caregivers on how to handle mobility and transfer-related problems; however, it is unknown how to handle the complexity of dementia-related impaired endurance, joint dysfunction, balance, and gait dysfunction and at the same time, take into consideration the person's decreased cognition, communication deficits, and behaviour problems. Aims and methods: The aim was to explore the effectiveness and efficiency of functional behaviour analysis (FBA) guided interventions of dyadic transfer-related behaviour in dementia care dyads. An experimental single-case research design was used. Two care dyads participated. Different methods of assessment were performed to gather the dyadic transfer-related behavioural problems. Transfers were recorded by video uptakes and to generate a hypothesis about dyadic transfer-related behavioural problems, the Dyadic Interaction in Dementia Transfer Assessment Scale (DIDTAS) was used. Results: The problematic transfer-related behaviour in care dyad 1 changed positively, as reflected by a decrease in discomfort verbally expressed by the person with dementia. A trend towards increased cooperation was observed among caregivers assisting in the transfer situation. In care dyad 2, a trend towards increased caregiver self-efficacy (SE) was observed between the baseline and completed intervention phases. The decreased resistiveness to care (RTC) exhibited by the person with dementia paralleled the increase in caregiver SE. Conclusion: Considering the findings of this explorative study, physical therapists could consider the development of tailored interventions guided by an FBA for complex dyadic transfer-related behavioural problems in dementia care dyads. ARTICLE HISTORY

Testing the Impact of FFC‐AL‐EIT on Psychosocial and Behavioral Outcomes in Assisted Living

“…The implementation of Function Focused Care also resulted in a significant decline in resistiveness to care among participants. The decline in resistiveness to care adds to prior findings that providing direct and simple statements and optimizing resident participation in functional activities can decrease resistiveness to care 37‐40 . These techniques are major components of function focused care.…”

“…The decline in resistiveness to care adds to prior findings that providing direct and simple statements and optimizing resident participation in functional activities can decrease resistiveness to care. [37][38][39][40] These techniques are major components of function focused care. Even the small decrease in resistiveness to care noted in this study is important for older individuals and their caregivers as resistiveness to care can impact the quality of life of residents and caregiver burnout, turnover, and risk of abuse.…”

Behaviour-directed Interventions for Problematic Person Transfer Situations in Two Dementia Care Dyads: A Single-case Design Study

“…The design is clinically relevant and features the opportunity to meet the complexity of person transferrelated behavioural problems in care dyads by tailoring and modifying interventions according to the care dyad's changing needs. This study is a replication of a former study by Thunborg et al (2019); however, it was implemented in another setting.…”

“…A transfer situation in an SCU is often constructed of one or two caregivers helping a PwD move, such as from sitting to standing or transferring from a bed to a wheelchair. A transfer situation is often complicated and in uenced by environmental, psychological, and physical factors and could be seen as a complex care dyadic behaviour involving both the PwD and the professional caregiver (Thunborg, Söderlund, & von Heideken Wågert, 2019).…”

“…What caregivers do and the way they do it affects the PwD and in uences the PwD's behaviour in a caring situation (Berg, Hallberg, & Norberg, 1998;Holst, Edberg, & Hallberg, 1999). One example is the resistiveness to care (Belzil & Vézina, 2015), which can also be referred to as a transfer situation (Thunborg et al, 2019). If a PwD displays resistiveness to care by striving backwards, for example, the caregivers might experience physical strain (Wångblad, Ekblad, Wijk, & Ivanoff, 2009), which in turn can result in uncompleted transfers and increased reciprocal struggling by the care dyad (Thunborg, von Heideken Wågert, Söderlund, & Götell, 2012).…”